17-1319 Question Title * 1. What is your first name? What is your last name? First Last OK Question Title * 2. What is the best daytime and evening phone to reach you? Daytime # Evening # OK Question Title * 3. What is your email address? OK Question Title * 4. What is your age? OK Question Title * 5. What is your current street address? If you are away at school, please use your school address. Address Address 2 City/Town State/Province -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP/Postal Code OK Question Title * 6. What is your gender? Female Male OK Question Title * 7. What’s the highest level of education you have completed? 1. Some high school 2. High school or equivalent 3. Some higher education/some college 4. Trade or technical school 5. Associate degree 6. Bachelor’s degree 7. Graduate degree (masters or doctorate) OK Question Title * 8. Which of the following describes your employment status? Select all that apply (i.e. if you are a student and working) 1. Employed full-time, working 30 hours or more per week 2. Employed part-time, working fewer than 30 hours per week 3. A full-time undergraduate student 4. A part-time undergraduate student 5. A full-time graduate student 6. A part-time graduate student 7. Retired 8. Not currently employed 9. Homemaker OK NEXT